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Operational Medicine 2001
GMO Manual

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General Medical Officer (GMO) Manual: Clinical Section

Adult Sexual Assault

Department of the Navy
Bureau of Medicine and Surgery


Introduction

The term adult sexual assault, as used in this section, applies to all such offenses (sexual assault is a criminal act) against persons who are 18 years of age and over, and not married to the alleged perpetrator. Sexual assault against children under the age of 18, and those incidents that occur within a marital relationship should be referred to the Family Advocacy Program and should be handled as child sexual abuse or spouse abuse (OPNAVINST 1752.2 and BUMEDINST 6320.70). Sexual harassment is covered by SECNAVINST 5300.26.

Family Advocacy Representative

The assessment of sexual abuse is a complex process involving many professionals including law enforcement, a family advocacy representative (FAR), and medical personnel. Coordination of the assessment is often difficult and confusing. Navy instructions direct family advocacy representatives (FAR) to take the lead role. The FAR is always the first person to contact in a sexual abuse case as mandated by Navy instruction. Most state statutes also require reporting to civilian authorities.

Considerations

All victims of sexual assault will be given as much credibility as a victim of any other crime: they shall be considered a victim of sexual assault when any type of sex is forced on her or him through any type of coercion, violent or otherwise, they shall be considered a victim of sexual assault, regardless of her/his behavior at the time of the sexual assault (e.g. fraternization, underage drinking, etc.), and they shall be considered a victim of sexual assault regardless of the assailant's relationship with the victim (e.g., boyfriend, acquaintance, co-worker, etc.).

Role of the Physician

The medical officer must ensure appropriate law enforcement and command notifications are made depending upon jurisdiction and per OPNAVINST 1752.1. This should include providing the victim with options concerning her/his involvement with investigative/legal personnel and possible consequences as outlined in OPNAVINST 1752.1.

The primary role of the physician is to meet the needs of the victim and to observe, describe, collect, and record findings. All victims of sexual assault will be treated with fairness and respect. All medical personnel will ensure the sensitive, coordinated, and effective management of sexual assault cases, including access to a victim advocate program and appropriate counseling. Sensitivity to the victim's emotional state is critical. Explain the availability of victim advocacy services and notify the on-call victim advocate, if desired by the victim.

The medical officer will conduct a medical examination and gather physical evidence as soon as possible, (if the assault occurred within 72 hours of the visit), paying particular attention to victim sensitivity and privacy. Allow the victim to receive medical care and emotional support and / or stabilization before detailed investigative interviews. A victim's written consent is necessary for all medical procedures. This is contained within the sexual assault kit. Sexual assault cases must be managed in compliance with SECNAVINST 5520.3. If the assault occurred more than 72 hours before the visit, the sexual assault kit does not need to be utilized; however a physical exam should be conducted and appropriate medical care provided to address pregnancy prevention (emergency contraception, STDs treatments, etc.), as well as counseling services.

Collection of physical evidence is not required in all cases of sexual assault, such as the case of a patient presenting for psychological assistance several days post-assault. These individuals should be referred for appropriate mental health counseling and should still be offered a physical exam and medical care.

References

  1. OPNAVINST 1752.1
  2. NAVMEDCOMINST 6310.3

Revised by CAPT Glenna L. Tinney, MSC, USN, MED-32, Bureau of Medicine and Surgery, Washington, D.C. (1999).


Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001

Health Care in Military Settings

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001

United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
33621-5323

This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

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